How much rates vary
Facilitymedian $1,202 · 10th to 90th $363 to $5,495Professionalmedian $676 · 10th to 90th $389 to $933
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $724.44 Typical High $933.25 | Professional | None | $354.81 | $724.44 | $933.25 |
BCBS Idaho Setting Facility Modifier None Typical Low $380.19 Median $1,584.89 Typical High $6,025.60 | Facility | None | $380.19 | $1,584.89 | $6,025.60 |
BCBS Idaho Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $977.24 | Professional | None | $562.34 | $794.33 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $363.08 Typical High $501.19 | Facility | None | $323.59 | $363.08 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $537.03 Typical High $676.08 | Professional | None | $309.03 | $537.03 | $676.08 |
Moda Health Setting Facility Modifier None Typical Low $316.23 Median $724.44 Typical High $5,495.41 | Facility | None | $316.23 | $724.44 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $446.68 Median $724.44 Typical High $933.25 | Professional | None | $446.68 | $724.44 | $933.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $870.96 | Facility | None | $588.84 | $588.84 | $870.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $512.86 Median $758.58 Typical High $1,096.48 | Professional | None | $512.86 | $758.58 | $1,096.48 |
Regence BlueShield Setting Facility Modifier None Typical Low $3,890.45 Median $5,495.41 Typical High $7,585.78 | Facility | None | $3,890.45 | $5,495.41 | $7,585.78 |
Regence BlueShield Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $870.96 | Professional | None | $562.34 | $707.95 | $870.96 |
Select Health Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $3,890.45 | Facility | None | $416.87 | $416.87 | $3,890.45 |
Select Health Setting Professional Modifier None Typical Low $269.15 Median $416.87 Typical High $616.60 | Professional | None | $269.15 | $416.87 | $616.60 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,412.54 | $1,621.81 |
United Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $741.31 | Professional | None | $363.08 | $501.19 | $741.31 |
22 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $331.13 Median $363.08 Typical High $467.74 | Professional | 52 · Reduced service | $331.13 | $363.08 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $144.54 Typical High $186.21 | Professional | 53 · Discontinued | $134.90 | $144.54 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $537.03 Typical High $707.95 | Professional | 54 · Surgery only | $501.19 | $537.03 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $109.65 Typical High $141.25 | Professional | 55 · Aftercare only | $100.00 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $72.44 Typical High $93.33 | Professional | 56 · Pre-op care only | $67.61 | $72.44 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $501.19 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $467.74 | $501.19 | $660.69 |
BCBS Idaho Setting Facility Modifier 50 · Both sides Typical Low $575.44 Median $2,344.23 Typical High $9,120.11 | Facility | 50 · Both sides | $575.44 | $2,344.23 | $9,120.11 |
BCBS Idaho Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $1,000.00 Typical High $1,258.93 | Professional | 50 · Both sides | $812.83 | $1,000.00 | $1,258.93 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $741.31 Typical High $870.96 | Professional | 54 · Surgery only | $489.78 | $741.31 | $870.96 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $85.11 Typical High $97.72 | Professional | 55 · Aftercare only | $56.23 | $85.11 | $97.72 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $660.69 Median $776.25 Typical High $1,174.90 | Professional | 63 · Small infant | $660.69 | $776.25 | $1,174.90 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $562.34 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $426.58 | $562.34 | $758.58 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $331.13 Median $363.08 Typical High $467.74 | Professional | 52 · Reduced service | $331.13 | $363.08 | $467.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $144.54 Typical High $186.21 | Professional | 53 · Discontinued | $134.90 | $144.54 | $186.21 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $537.03 Typical High $707.95 | Professional | 54 · Surgery only | $501.19 | $537.03 | $707.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $109.65 Typical High $141.25 | Professional | 55 · Aftercare only | $100.00 | $109.65 | $141.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $72.44 Typical High $93.33 | Professional | 56 · Pre-op care only | $67.61 | $72.44 | $93.33 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $501.19 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $467.74 | $501.19 | $660.69 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,258.93 Typical High $1,621.81 | Professional | 50 · Both sides | $1,258.93 | $1,258.93 | $1,621.81 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $758.58 | Professional | 54 · Surgery only | $588.84 | $588.84 | $758.58 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $109.65 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $109.65 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $812.83 |
Where Idaho sits
The same service costs 5.0 times more in Alaska than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Idaho· 9th of 51
$676
AK $1,380UT $275
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.